Mothers on the edge: Women still delivering in boats, unipots

KALANGALA - The cry of a newborn usually brings joy in a well-equipped maternity ward, surrounded by midwives and medical equipment. 

But for many mothers in Kalangala’s scattered islands, childbirth is a life-threatening gamble, sometimes unfolding in boats, on lake shores, or in abandoned structures.
 
Such was the case on the night of May 12, when Mariam Ayangakyamwine, a resident of Kitobo landing site on Kitobo Island in Bufumira sub-county, went into labour. 

She needed to be rushed to Kalangala Health Centre IV, but her husband, Joseph Kasibante, couldn’t find a fast boat, engine, or even fuel in the middle of the night. 

“We had to wait, until morning when some fishing boats returned and also collect money to buy enough fuel. 

“The situation on Kitobo Island is not conducive for mothers, since the island lacks a health facility,” Kasibante said. 

Kitobo, with a population of over 4,000, relies on distant facilities on Bufumira or Lulamba islands. 

By the time Ayangakyamwine reached the Mwena landing site on Buggala Island in the morning, she could no longer bear the pain. 

With no time to get to the health centre, she gave birth on the shoreline, with the help of Rashida Nakabuubi, in an abandoned uniport. Fortunately, she delivered a healthy baby girl. 

“I have so far witnessed over 10 women giving birth from this shoreline after failing to reach the health facility. After delivery, we transport them for further management,” Nakabuubi said. 

This wasn’t an isolated case. Just last month, another woman gave birth in a boat while being transported from Jaana Island in Bubeke sub-county to Bubeke Health Centre III. 

The boat’s engine failed mid-journey, and the coxswain waved a life jacket in distress, until a passing medical team responded. 

“We were heading for a health monitoring visit when we saw life jackets and jerrycans being waved. When we reached them, we found a mother in labour and helped her deliver safely on the lake,” Sr Teddy Namuli, the Kalangala district HIV focal person, said. 

While the Government has made efforts, such as providing a water ambulance, mothers continue to risk their lives. 

The main challenge lies in operational costs: A trip from Kitobo to Kalangala Health Centre IV requires up to 200 litres of fuel in a powered boat, while wooden boats still need 20 litres of petrol, which remains expensive for most islanders. 

Kalangala district chairperson Rajab Ssemakula called on the health ministry to invest in fibreglass swift boats for islands without health facilities. 

“Ambulance employees are paid monthly, yet they don’t work. Instead of their salaries, let the ministry purchase boats that could be on call on different islands for emergencies,” Ssemakula said. 

The Government is also constructing a maternity ward at Bubeke Health Centre to improve access for mothers from Nkese, Buyange, Jaana and Bunjaazi islands.

Health outreaches 

Kyamuswa county MP Moses Kabuusu wants quarterly integrated health outreaches to serve islanders with chronic conditions and expectant mothers. 

“Even our mothers who can’t afford antenatal visits could get help through these outreaches and prepare for delivery in time with the help of medical experts,” he said.
 
Kalangala’s 64 inhabited islands are served by only 16 health units, with eight located on Buggala Island, the administrative centre of the district’s 84 islands. 

Only two health centres, Bukasa and Kalangala, are at health centre IV level, and the entire district lacks a hospital.